BLAZE KOTLAROVSKI Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049062707

License Status

NOT RENEWED

Business

First Name

BLAZE

Last Name

KOTLAROVSKI

Business Name

BLAZE KOTLAROVSKI

Original Issue Date

12/20/1974

Effective Date

12/20/1974

Expiration Date

01/01/1997

City

CHICAGO

State

Zip

60613

County

COOK

Ever Disciplined

LastModifiedDate

10/17/2005